Factors associated with paediatric revision adenoidectomy: The Flinders experience

Abstract

Background: Adenoidectomy is performed to treat obstructive and/or infective conditions. Adenoid regrowth following adenoidectomy may cause recurrence of symptoms. This study investigated the revision rate and risk factors associated with symptomatic paediatric patients requiring revision adenoidectomy in our institution. Methods: A retrospective study of 1,359 paediatric patients who had an adenoidectomy with or without concurrent otolaryngology surgery at Flinders Medical Centre between 2007 and 2017 was conducted. Patients were identified through the hospital operating room management information system. Case notes were reviewed to identify patient and surgical factors. Univariate analysis was performed using relative risk to determine risk factors of revision adenoidectomy. Results: Fifty-seven patients required revision adenoidectomy, with two of these patients requiring an additional secondary revision (i.e., patient’s third surgery overall). This resulted in 59 cases of revision adenoidectomy overall (revision rate =4.3%; 59/1,359). The median time between primary and revision surgery was 21 months (range, 4–96 months). Younger patients ≤6 years (RR =2.99; 95% CI, 1.29–6.90) and patients with otitis media with effusion (RR =6.83; 95% CI, 3.57–13.07) were more likely to undergo revision surgery. Concurrent tonsillectomy was associated with fewer revision surgeries (RR =0.33; 95% CI, 0.20–0.55). Gender, obstructive indications, recurrent upper airway infection, concurrent nasal surgery, surgical technique, surgeon grade and adenoid size were not significantly related to risk of revision. Conclusions: Young age and otitis media with effusion requiring myringotomy with or without ventilation tube insertion was associated with increased risk of revision adenoidectomy.